BACKGROUND AND OBJECTIVES:Frontotemporal lobar degeneration (FTLD) can present as a behavioral or language variant (bvFTLD or a primary progressive aphasia [PPA], or as a syndrome with parkinsonism, such as corticobasal syndrome [CBS] or progressive supranuclear palsy [PSP]). The incidence of FTLD varies in epidemiologic studies, reaching 3 per 100,000 person-years. Only few data exist regarding survival times. We evaluated incidence and survival rates in a population-based registry with high coverage in Southern Germany. METHODS:The epidemiologic ALS-FTLD registry Swabia covers a population of 8.4 million inhabitants in south-west Germany. Raw and age-standardized incidence rates, as well as incidence rate ratios (IRR) with 95% CIs were calculated. Median survival time was estimated for different FTLD variants using the Kaplan-Meier method. RESULTS:Between 2015 and 2022, 515 patients with FTLD (mean age at diagnosis 68.0 ± 9.5 years, 59.8% men) were registered. The median diagnostic delay was 24.8 months. The most common variant was bvFTLD (n = 185, 35.9%; 66.5% men), followed by PPA (n = 147, 28.5%; 51.0% men), PSP (n = 133, 25.8%; 62.9% men), and CBS (n = 22, 4.3%; 50% men). The overall FTLD incidence was 0.77 (95% CI 0.71-0.84), and the age-standardized incidence was 0.76 (95% CI 0.69-0.82) per 100.000 person-years. The age-standardized incidence was higher in men than in women, with an IRR of 1.73 (95% CI 1.44-2.00). In men, incidence increased from the age 50 years, primarily due to bvFTD, whereas in women this rise was primarily due to PSP. The median survival (N = 392) from diagnosis was 53.6 months (95% CI 50.9-62.0) overall, 73.1 months (95% CI 63.6-82.8) for patients with PPA, 42.8 months (95% CI 35.1-64.3) for patients with bvFTD, and 49.5 months (95% CI 39.2-53.7) for patients with PPS/CBS. DISCUSSION:We observed a raw incidence rate of 0.77, thus considerably lower than in most previous reports. Incidence was substantially higher in men than in women. The prognosis from the time of diagnosis depended highly on the specific FTLD subtype. Our data are based on the large sample size and high capture rate of a central European population-based registry.
Periprosthetic joint infection (PJI) is one of the most severe complications in hip arthroplasty, and treatment of PJI is associated with high re-infection rates and significant loss of quality of life for patients, as well as socio-economic impact to health systems. Antimicrobial coating of implants with silver is a promising option to improve the outcome of PJI. However, there is no data from randomized control trials on silver-coated versus standard non-silver-coated implants in patients with PJI. Therefore, the aim of the current study is to assess clinical outcome for the use of silver-coated hip implants (further referred to as IP-coated) versus non-IP-coated implants in patients requiring surgical revision for hip PJI. This is a multicenter confirmatory interventional randomized controlled superiority single-blinded study with two stages: pilot stage (part A) and pivotal stage (part B). Patients indicated for unilateral cementless acetabular and hip stem revision due to chronic periprosthetic infection planned for single-stage or two-stage surgical procedures are included. Patients will randomly be assigned either to the IP-coated or the non-IP-coated implant group. The primary outcome parameter is infection-free survival within 12 months after hip PJI. The underlying hypothesis is that the IP coating significantly reduces the risk of periprosthetic reinfection compared to the non-IP-coated implants. Secondary outcome parameters include data on the safety and performance of the prostheses through a 2-year clinical follow-up, including patient-related outcome parameters, such as Harris Hip Score, EQ-5D, radiographical assessment, and blood silver concentrations. An adaptive study design is planned with the inclusion of 268 subjects according to initial sample size calculations. Upon follow-up of 134 patients for 12 months or inclusion of 90
The standard local therapy for breast cancer is surgery. Postoperative seroma formation is one of the most common and serious complications after breast surgery for primary breast cancer, especially in patients undergoing mastectomy with or without implant-based breast reconstruction. Seromas may lead to infections and wound dehiscence, which can result in loss of reconstruction, ugly scars and poor cosmetic outcome.. To date, the cause of seroma development has not yet been clarified. The main objective of the multicenter SerMa study is to identify a subgroup of patients with an increased risk of developing seromas based on immunological or inflammatory markers in a planned cohort of 2200 subjects. The study is designed as international, prospective cohort study in cooperation with the EUBREAST Network (European Breast Cancer Research Association of Surgical Trialists). articipating study groups are AGO-B, AWOgyn and OPBC. Patients with primary breast cancer or ductal carcinoma in situ (DCIS) planned for mastectomy with or without reconstruction can participate in this study (study group 1 and 2). Study group 3 includes patients at high risk for breast cancer planned for risk-reducing subcutaneous mastectomy and implant-based reconstruction. Study group 4 includes healthy women with implant insertion for exclusively cosmetic reasons. Currently, the logistics phase with 50 patients has been completed, which was carried out to optimize the preservation of blood samples and seroma fluid. To achieve the primary endpoint - the identification of a patient group with an elevated risk of developing a seroma - it is planned to examine the groups with and without postoperative seroma formation regarding immunological markers in seroma fluid as well as in blood samples. In addition, local microbiome analyses, as well as tumor analyses with focus on microenvironment will be performed to differentiate possible carcinoma-specific immunological processes. To answer the question whether differences are caused by immunological or cancer-related reasons, groups with and without postoperative seroma formation as well as groups with or without breast cancer are compared. Following the current finalization of the logistics phase the study is open for recruitment, The study is currently expanding worldwide. 2200 participants in total. N. Ditsch, M. Koepke, N. Pochert, U. Jeschke, M. Schneider, M. Reiger, C. Traidl-Hoffmann, Y. Masannat, A. Mattmer, S. Hunstiger, J. Sagasser, C. Dannecker, M. Wild, C. Hinske, M. Hauptmann, S. Hartmann, H. Kahl, D. Krug, N. Krawczyk, K. Stemmer, D. Rezek, A. Raue, M. Gasparri, R. Reitsamer, J. Jelinska, G. Cakmak, E. Bonci, R. Wuerstlein, V. Fink, V. Bjelic-Radisic, M. Thill, C. Heitmann, W. Weber, E. Stickeler, A. Lebeau, P. A. Fasching, H. Kolberg, T. Reimer, L. Bauer, U. Beckmann, B. Aktas, S. Hasmueller, U. Schlembach, R. Di Micco, J. De Boniface, O. Gentilini, M. Untch, T. Kühn, M. Banys-Paluchowski. Start of SerMa - EUBREAST 5 (Seroma of the Mammary Gland) study (NCT05899387) [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-08-12.
Guidelines recommend a structured symptom screening (SC) for especially advanced cancer patients (CPs). The aim of this multicenter German prospective quality assurance project KeSBa (Kennzahl Symptom- und Belastungserfassung) was to gain knowledge on SC procedures in Oncology Centers (OCs) for advanced cancer patients and a first impression on the consequences of SC. The KeSBa project consisted of three phases: pilot, 3 months screening and feedback phase. Participating OCs decided to use either the Minimal Documentation System (MIDOS) or the Integrated Palliative care Outcome Scale (IPOS) and defined the cutoff values for positive screening results. Out of 172 certified German OCs, 40 (23
Background: The aim of this study was to evaluate ultrasound as a routinely used procedure and extended physical examination in geriatric patients in acute care. Methods: Prospective study of 86 patients using ultrasound as a screening examination (abdomen, basal sections of the thorax, thyroid glands) under comparative use of a hand-held ultrasound device (HHUSD) and a high-end ultrasound (HEUS = gold standard). Results: In 20/86 (23.2%) clinically relevant findings with therapeutic consequences were found (pleural effusion, urinary retention, choledocholithiasis metatases, colon tumor). In 22/86 (25.6%) patients, additional questions existed besides the screening indication: tumor search (9.3%), anemia (5.8%), liver value elevation (5.8%), dyspnea (5.8%), splenic pathologies (2.3%), weight loss (1.2%), infectious focus (1.2%), diarrhea (1.2%), intra-abdominal hematoma (1.1%), abdominal aortic aneurysm (1.2%). The most common sonographic findings included: cholecystolithiasis (32.6%); right pleural effusion (31.4%), thyroid nodules (30.2%), renal cysts (27.9%), and fatty liver (26.7%). There were significant differences in sizing between HHUSD and HEUS (kidneys, pancreatic corpus and pancreatic caudal diameters, portal vein, left hepatic vein) without diagnostic relevance. Conclusion: The extended screening by ultrasound provided important answers to classical questions in geriatrics (e.g. urinary retention, volume deficiency/pleural effusion) in many cases. The new findings had therapeutic consequences in one fifth of the patients. The HHUSD can be used in screening.
